Healthcare Provider Details

I. General information

NPI: 1306086707
Provider Name (Legal Business Name): SUMA MARIAM KURIAKOSE PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2009
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 THE GRN STE A
DOVER DE
19901-3618
US

IV. Provider business mailing address

73 MCCORMICK WAY
LINCOLN UNIVERSITY PA
19352-9051
US

V. Phone/Fax

Practice location:
  • Phone: 302-288-0670
  • Fax:
Mailing address:
  • Phone: 646-469-9679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberJ1-0004013
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: